Research master thesis | Psychology (research) (MSc)
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Using a wide variety of clinical questionnaires might hamper the communication between clinicians and researchers in Routine outcome monitoring (ROM). Linking test scores to T scores as a common...Show moreUsing a wide variety of clinical questionnaires might hamper the communication between clinicians and researchers in Routine outcome monitoring (ROM). Linking test scores to T scores as a common metric might be a solution. Item response theory (IRT) is the preferred way to estimate T-scores. However, required software and a large dataset is needed for that. In this thesis, two methods were used to arrive at a common metric for often used questionnaires and their subversions: the BSI, BSI-18, the DASS-42 and the DASS-21. As one method, we used an IRT approach to estimate theta-based T-scores, leading to crosswalk tables. For the second approach, conversion formulas were estimated for raw scores to calculated T-scores based on the best-fitting regression equation between the raw scores and the previously estimated theta-based T-scores. Crosswalk tables and conversion formulas are both alternative ways to link individual scores to a common metric. It was investigated if conversion formulas are valid by comparing calculated T-scores with theta-based T-scores. The agreement between calculated T-scores and theta-based T-scores were high for all questionnaires except the DASS-42. The agreement was also lower at the extreme ends of the questionnaires (T= < 50 and T= >75). All in all, conversion formulas seem to be a good alternative for estimating a common metric. Offering different options to calculate common metrics can help in improving the communication between professionals in the clinical field. Increased involvement and better communication in ROM is able to increase the quality of mental health care.Show less
Current mental health care systems evaluate the quality of care mainly based on the outcome of treatment. However, for patients, the time spent to achieve this outcome is a relevant factor which is...Show moreCurrent mental health care systems evaluate the quality of care mainly based on the outcome of treatment. However, for patients, the time spent to achieve this outcome is a relevant factor which is often overlooked in modern health care systems. For insurance providers, the incurred cost of treatment is an important criterion for quality of mental health care. In order to offer truly valuable care in the eyes of both of these parties, the result of treatment must measure up to its required effort, both temporal and financial. Including cost and duration in the evaluation of health care will ultimately benefit all parties involved. Therefore, the present study tests the validity of two new quality indicators based on the principle of value-based health care. Value here is defined as outcome relative to cost or outcome relative to duration. Data used was collected by Routine Outcome Monitoring at several outpatient clinics providing specialized mental health care in the Netherlands. MANOVA testing revealed that the two new quality indicators showed larger differences in quality of care than outcome alone. These results were supported by differences among clinics in the cost and duration of treatment per improved and recovered patient. Based on the results of this study, the use of quality indicators of value-based health care over outcome alone in the mental health care sector is advised.Show less
